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As a teacher our job is not just to impart knowledge to the students who are placed in our care, but also to nurture them and give them support during their difficult times. As a teacher, first at Kasturba Medical College,Manipal and now at Kasturba Medical College, Mangalore, I’ve often been approached by students to discuss matters that included difficulty in coping with medical school to personal problems at home and among friends.Manipal and to some extent Mangalore does that to you. The students come from various backgrounds and many from countries across the world, and it is often difficult to adjust to a totally different environment, especially so for many who are leaving behind the shelters of their home for the first time!
In a phone conversation with one such student a couple of weeks ago, she found it proper to gently let me know that she was deeply lacking self-esteem and at times hurting from it so badly that she was afraid to be alone. Naturally knowing her as well as I thought I did, I thought to myself, “How could anyone with all she had going for her feel like this?”
I began to think that she was being a bit selfish and her confession was a way to shirk some of the responsibilities of medical school. A good family background, loving and caring parents who thought the world of her, her education almost completed, a maturing relationship with an intelligent guy, the list could go on forever.
I listened intently as she explained how no matter what she did it never seemed good enough. She tried to make time for everything in her life but still felt she was not doing enough for others to please them. The most painful part of the conversation was to hear her describe how she felt almost certain her boyfriend and others were conspiring against her and not willing to help deal with these issues that he insisted were non-existent. She was driving him crazy. The allegations had to stop or he was going to leave.
She went into detail and unearthed the dark side of low self-esteem that cloaks itself in smiles and busy work to go undetected by loved ones to aid in stopping this internal destruction. Once upon a time, she was the best of the best. She worked the hardest. She got the best grades. She was the smartest person that her friends knew. She described how she thought her outer appearance unacceptable and felt that others were often criticizing her. After coming to Manipal, the feelings worsened. Guess what? Once she got to medical school…everyone was the same as her.
She felt that everyone around her was more well dressed, more popular and that she was looked down upon for being a small-town girl! These feelings were keeping her from trying new things, allowing poor performance and lack of concentration in school and work. She didn’t want things this way. It was hard for me to find out this bubbly girl, who was full of energy and zest was actually made of sand.
I found myself feeling guilty for putting her down earlier in the conversation. I felt helpless giving her the usual: “Things will turn out okay. ”
My experience as a doctor, especially during my stints at various hospitals before joining as a full time teacher, allowed me to understand that none of these quickie suggestions help much when people with low self-esteem have forgotten or don’t know how to make themselves feel better, or worse yet, don’t know it’s a self-esteem issue and just go on in this downward spiral. Feeling guilty or sorry for her wasn’t going to help either one of us. I felt that if she had the courage to tell me, it was my responsibility to help.
When I asked what had brought this on or how long it had gone on I expected to hear a couple of weeks but when she said, “Probably all my life but more so in the last year.” I almost fell over in my chair! She looked okay. How did I miss the clues? She’s so normal.
Luckily she had enough confidence and trust in me to ask me for help. I confided in a colleague at our hospital about the situation and he was able to recommend a therapist that could help. She made an appointment the following week. We anticipated the visit with hope. I could see a small change now that help is a few weeks away.
She came from her first visit hopeful. She was able to figure out that a lot of the self-criticism came from her mother’s strict parenting methods that were often critical. Although she had an issue to work on with her self-esteem she did like herself. It was more a problem with the way she felt others perceived her. Armed with this new hope, communication with her boyfriend seemed to flow better now that she was aware it was her distorted view of self and others that was filling her mind.
My student was lucky she had friends to listen and the ability to even realize there was a problem. Unfortunately there are people not aware of these feelings and depression or low-esteem. I thought of the people who may feel ashamed to ask for help, even if they are tired of feeling bad. I thought of people who don’t have people who they can turn to without being laughed or scorned at.
Sometimes we forget, a person can suffer just as much from wounds within, as the more easily visible ones. My student didn’t have to behave any strange way to make me believe a problem existed, that’s why it was difficult for me to comprehend that her function funny and “normal” person had an emotionally appalling conflict brewing inside her.
Change for her won’t come overnight still her effort will be well worth the result.